Provider Demographics
NPI:1417211590
Name:ELIOS ANESTHESIOLOGY GROUP, PA
Entity Type:Organization
Organization Name:ELIOS ANESTHESIOLOGY GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VASILIKI
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-708-4545
Mailing Address - Street 1:1938 WEDDINGTON RD STE K
Mailing Address - Street 2:
Mailing Address - City:WEDDINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28104-8318
Mailing Address - Country:US
Mailing Address - Phone:704-708-4545
Mailing Address - Fax:704-708-4536
Practice Address - Street 1:1938 WEDDINGTON ROAD SUITE K
Practice Address - Street 2:
Practice Address - City:WEDDINGTON
Practice Address - State:NC
Practice Address - Zip Code:28105-8318
Practice Address - Country:US
Practice Address - Phone:704-708-4545
Practice Address - Fax:704-708-4536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400450207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty